Provider Demographics
NPI:1255541769
Name:JACOBS, FRANK MAC (LMFT, LMHC, CAP)
Entity type:Individual
Prefix:MR
First Name:FRANK
Middle Name:MAC
Last Name:JACOBS
Suffix:
Gender:M
Credentials:LMFT, LMHC, CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 BELCHER RD. S.
Mailing Address - Street 2:#B-4
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33771
Mailing Address - Country:US
Mailing Address - Phone:727-531-7988
Mailing Address - Fax:727-531-0950
Practice Address - Street 1:1501 SOUTH BELCHER RD.
Practice Address - Street 2:#B-4
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33771
Practice Address - Country:US
Practice Address - Phone:727-531-7988
Practice Address - Fax:727-531-0950
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL647101YA0400X
FL3378101YM0800X
FL2002106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist